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Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Driver’s License Number *

Age *

Under 18
18–24
25–34
35–44
45–54
55+

City & State you dash in *

How long have you been a DoorDash driver? *

Less than 1 month
1–6 months
6–12 months
Over 1 year

Which other gig apps do you currently use (if any)?

Uber Eats
Grubhub
Instacart
Amazon Flex
Lyft/Uber
Other

How many hours per week do you work on DoorDash? *

Less than 10
10–20
20–30
30–40
40+

What times of day do you usually dash? *

Morning
Midday
Afternoon
Evening
Late Night

What are your preferred zones to dash in, and why? *

What type of vehicle do you use? *

Compact/Economy
Midsize
SUV
Pickup
Bicycle
Motorcycle/Scooter
Rented vehicle

If Rented, please specify

What best describes your current driving record? *

Clean (no violations or accidents in the last 3 years)
Minor violations (e.g., speeding ticket, expired tag)
Major violations (e.g., DUI, reckless driving, license suspension)
At-fault accident(s) in the last 3 years
Prefer not to say

If you selected “Major violations” or “At-fault accident(s),” please describe any major violations or accidents and when they occurred:

What are your biggest challenges with gig work? (Select up to 2) *

Vehicle maintenance
Fuel costs
Unpredictable earnings
Unsafe delivery areas
Parking issues
App glitches/support
Other

How much do you spend on gas per week (approx.)? *

Under $25
$25–50
$50–75
$75–100
$100+

Do you track mileage and expenses for taxes? *

Yes
No
Sometimes / Not sure how

What are your average weekly earnings (after expenses)? *

Under $100
$100–250
$250–500
$500–750
$750+

in, Rented, specify

Do you rely on DoorDash income as your: *

Primary source
Secondary source
Side hustle / Extra cash

What financial goals are you working toward with gig work? *

Which of the following services would you be interested in? *

Affordable weekly rental cars
Discount fuel
Tax/accounting help
Maintenance discounts
Dashers-only lounge
Insurance assistance
Other

Have you ever used a rental car to drive for DoorDash? *

Yes
No
Considered it, but haven’t yet

If Yes, which one?

What would be an ideal weekly rental price? *

Under $150
$150–200
$200–250
$250–300
Over $300

How likely are you to recommend dashing to others? (1 = Not at all, 5 = Definitely) *

What improvements would you like to see for DoorDash drivers in your area? *

Any other comments, concerns, or suggestions? *

Driver's License *

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DoorDash Profile *

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